Tag Archives: Dads

Dads are often the first ones to notice something isn’t quite right. They’re the ones on the front lines with us and their level of support (positive or negative) can seriously affect how well (and how quickly) a mom recovers from her Perinatal Mood & Anxiety Disorder.

The kicker, however, is that dads are also susceptible to mood disorders of their own as they start out into fatherhood as well – and they’re at an even higher risk of this if mom has her own issues going on.

Tonight, we’ll be discussing a whole range of things involving the way Perinatal Mood & Anxiety Disorders affect the family as a whole, with a specific focus on Dads. I hope you’ll join us at 9pm ET. See you then!

It is easy to do given that Dad is not the one undergoing a huge physical transformation in just nine short months. But he is still undergoing a psychological change. He is father. There is a new person growing inside his partner for whom he is jointly responsible.

Father.

A two-syllable word yet so powerful.

Any man can create a baby. It takes a real man to hang around and be involved.

Once a woman gives birth, the attention shifts to baby. Then back to her. In fact, one of the first things we hear even when celeb moms give birth is that “Mom and baby” are doing just fine. What about Dad? How is he doing? Did he faint at the sight of the needles? How IS he doing emotionally? Oh oops..wait. It’s not okay to talk about a Dad’s emotions. He’s a man. Manly men are brawny. They grunt, growl, pound each other’s chests, howl, and all that caveman stuff. Right? Right?

Wrong.

Dads today are involved more than ever.

I can’t tell you how many Stay At Home Dads I know on Twitter. Or how many Dads who do work and are actively involved in their children’s lives.

And let’s not forget our current Commander in Chief who is father of two young girls.

You can also find Dad to Dad support at Twitter.com by simply utilizing the hashtag #DadsTalking. These Dads offer a large base of support, weekly chats, and a website. You can also follow them @DadsTalking.

Involved Dads deserve recognition. They deserve to be encouraged without being torn down, nagged, or attacked. Sure, he may not do things as perfectly as you think they should be done, or even the way you would do them at all, but at he is doing his best in his own way. Just as another mom does things in her house her own way, so does your husband/partner. Give him kudos when he helps out. Let him know how much you appreciate everything he does for you, for your children, for your family. It’s particularly important because according to the National Fatherhood Initiative, 24 million children are living without fathers.

It’s hard to provide recognition when struck down by a Postpartum Mood Disorder. Dads, know that if your wife is struggling with a Mood Disorder after a birth, she is grateful for any help you are providing. One day she will thank you for everything you did to help her recovery. She needs someone to listen, to help with daily household tasks, to let her know that she is not alone. She may need to sit in silence. She may need to rest. She may need you to watch the baby if she goes to therapy. Staying positive and listening with an open mind is one of the best things you can do for her.

Fathers of the world, thank you. Thank you for being man enough to hang around for the tough part. We, your partners and children, are eternally grateful.

Today’s Postpartum Voice of the Week post was written by my husband, Chris. He’s been through hell right along with me. We have both learned so very much from this long bumpy road. My husband has not only survived my own bouts with Postpartum Depression, he’s also survived his own depression and overcome addiction to Marijuana. He has been sober for two years and counting. I have watched him grow as a father, a friend, a person, and as a husband. Amazing does not even begin to describe his transformation. We have a long way to go and our marriage has been dashed against the rocks more times than we care to admit. But through it all, we have managed to cling to each other and God. Smooth sailing may happen once in awhile but we both rest confidently knowing God will carry us through anything else that comes our way. Recently, he has become more active in supporting fathers as they journey through their own Depression after the birth of a child or through their partner’s depression. Believe you me, he’s got some experience under that belt of his. He just started a blog to share his insight. You can visit him at Daddy’s Down. Swing on by and show him some love! And now, I give you my husband’s words of advice.

“Congratulations on your new baby!” “How’s baby?” How’s the new Mommy?”

Someone I know just had a new baby. These are the questions that I heard asked on Facebook. They are good questions. They are appropriate questions. The only thing I didn’t hear among the accolades and congratulations is “Dad, how are you doing?”. I understand everyone is concerned about this precious new life, so delicate and innocent. That baby needs the love and support. Mom, well she just sweated and toiled through 10 hours of labor, not to mention the nine months of swollen feet, cravings, morning sickness and whatever else that baby growing inside her threw her way. That Mom needs the love and support as well. But Dad often gets forgotten. He is an important part of the equation too. After all, who do you think is going to be there to provide the love and support that baby and Mommy need after all the well-wishers are gone?

Daddy is under a lot of stress to perform. He was probably raised to be a man and not share his emotions. If Mommy and baby are well, there is still stress and adjustment. But if Mommy is not well, and is suffering from a postpartum mood disorder, the stress and adjustment can be magnified. Dad may be handling it all fine, or he could just be faking it. Making him feel like he matters is an important part of the support that he needs during this time. And if Daddy isn’t well because he is suffering from depression himself, as one in ten new fathers do, he is not able to be there for his family to give them the support that they need.

So, here are 5 things that you can do for Daddy to help him get through this time and to help him be there for his family.

Give him a gift. It may sound small or inconsequential, but Mommy and baby have received all kinds of goodies; flowers, gift baskets, stuffed animals. It doesn’t have to be big, but something to help him know that he hasn’t been forgotten.

Offer to babysit so that he can have some time alone with Mommy. Chances are since baby has been born that Mommy and Daddy haven’t had a moment to themselves. Daddy needs some time with his partner, if for no other reason but to have a brief moment of the way things were before his whole world changed.

Take Daddy out for dinner or coffee. Daddy needs to know that his friends and family haven’t abandoned him. Usually family and friends don’t want to bother Daddy when he has a new baby at home. Trust me, Daddy needs to know that even though his whole world has changed at home, he hasn’t lost his friends too.

Encourage him. Daddies need to know that they are doing a good job too. Hey, Daddy may be new to this baby thing, and it is really easy for him to feel like he doesn’t know what he is doing.

Just ask him how he is doing. He very well may not be honest, but he will at least know that you care. Even if no one does any of the other four things, this is one thing that you can do that will go the furthest in making Daddy feel like he is important.

I remember when my first two kids were born. I remember the joy I felt knowing they were a part of me and that I was their father. I also remember feeling neglected and unappreciated by everyone else around me. While suffering from depression after the birth of my second child, this feeling only helped to feed the depression. I felt as if my entire world had been turned upside down, my friends had left me, my family had abandoned me and that I had lost my wife forever. I wish that someone had asked me how I was doing or had given me some time away with my wife or with a friend. It would have gone a long way to make me feel important and wanted.

Daddy has to be taken care of too. Part of taking care of his new family is making sure that he is taken care of. If Daddy is depressed or is struggling to maintain his sanity, then it can make it impossible for him to be there for his family. “Being there” doesn’t just mean physically, but mentally as well.

Let’s just make sure that Daddy doesn’t get forgotten in all of the excitement. His role is important too, and it is most often appreciated by everyone, but if that appreciation is not expressed it can leave Daddy feeling like he is not important. Let’s face it, we all need to feel important.

The person who coined the phrase, “Sleep like a baby,” clearly never had one. Granted, when babies DO sleep, they are peaceful. For all of what seems like two seconds. And then bam. Right when you hit the couch, they’re up again. Diaper. Feed. Burp. Walk. Rock. Glare at the pile of laundry skulking off to Vegas and wondering how you can hitch a ride without anyone calling CPS. Yeah, I think we’ve all been there a time or two.

I remember the early days. Blurring together, feeling like I had just closed my eyes only to have hubs waking me to inform me of Babe’s infinitely empty stomach. But I JUST nursed! No, it was about two hours ago. What the… really? So I’d jumproll slowly creep out of bed as I cursed the boob monster responsible for ripping me from my nest.

Sleep. My best friend in college. The reason I had no classes before noon my senior year. The reason my last quarter of college only had me in one class well after noon and only twice a week. I mean, really. Whole days of sleeping in – who is going to begrudge you that in college?

Once the kids are in school, I tell myself, I will take the first day off. I will put all three of the children on a bus at 635 a.m. because that’s what time it gets here, I will smile and wave. And then? Then I will Irish Jig ALL the way up the damned driveway, happily skip into my bedroom, reset my alarm for 2pm, and close my eyes. Think I’m kidding? August 5, 2012. I.WILL.SPEND.THE.ENTIRE.DAY.IN.BED. It’s on my calendar.

They say you can’t catch up on sleep. Once you miss it, it’s gone. No sleeping in on the weekend will recapture the sleep you missed out on because Junior decided 345am was an awesome time to wake up and play with trains. Or because Princess decided that 213am was the new 7am. Nope, you’re so screwed out of that time. I don’t know that I believe that. I always feel better after sleeping in on a Saturday.

So let’s get to just talking – how are you sleeping? Falling asleep easy? Feel rested when you wake up? Or are you struggling to fall asleep? Waking up feeling like you never quite got the rest you should have in the hours you were sleeping? Or are you not sleeping at all? Sleep deprivation does feed into Postpartum Depression. And Postpartum Depression? Yeh, it decreases your quality of sleep. Lovely. Oh, the havoc of sleep deprivation!

I will say this – prior to becoming a parent, coffee was not my best friend. It is now my holy grail. For without it, I would never survive.

How do you survive your sleeping issues? What works for you? Any tips for moms with PPD currently struggling with sleep issues? Toss ’em out there into Comment Land. I’m sure there are some Moms in need of suggestions!

When a new mom struggles with Postpartum Mood Disorders, her absolute first line of defense and support is her partner/spouse. If she has no support from the person to whom she is closest, the chasm into which she finds herself opens deeper, wider, and threatens to swallow her forever. A new mom turns to those closest out of sheer instinct. It’s a bit like falling off a cliff and reaching out for anything you can grab a hold of as you fall. If there’s nothing there or it breaks under the weight, you continue to fall with an unrooted twig in clasped in your hands and dirt under your fingernails.

Oftentimes, loved ones are the first to notice something is not quite right with Mom. They notice the lack of sleep or the increased sleep. They notice the irritability. They notice she does not want to hold the baby or spend time with them. They notice the housework piling up and Mom curling up in the corner. But they do not know how to tell Mom. They do not know where to turn for help. They do not know what to do. Instead they stand there. Watching. Helpless. Sliding toward hopelessness.

This is why education about Postpartum Mood Disorders is so absolutely important.

Husbands/Partners are especially vulnerable because they are left picking up the slack if Mom does not improve or seek treatment. Often this may create resentment between a couple and harm the marriage, sometimes irreparably. A harsh environment of anger, irritability, resentment, and discord seeps into the home as a result. This very environment has nearly destroyed my own marriage. Even six years later it still persisted, it’s ghost inserting itself into every interaction and conflict. We are FINALLY dealing with this negativity head-on now.

How do you prevent something like this from happening? I wish there was an easy answer. But alas, there is not.

A Postpartum Mood Disorder sneaks into life much like a thief in the night. It steals things like happiness, sanity, serenity, and harmony. Evil little bastard, really. Thing is, just as with any other life event, you can prepare for its arrival even if it may or may not happen. It’s a bit like installing a security system with alarms to go off to keep you safe. Even if this is your first pregnancy, it is absolutely imperative to educate yourself about the signs and symptoms of Postpartum Mood Disorders including how to recognize depression in your husband/partner.

Up to 50% of dads with a depressed partner will experience a form of depression called Paternal Postnatal Depression. It’s real, it happens, and two depressed parents make for a very tense household. There’s yelling, shouting, uncomfortable silence, judgment, and misunderstandings which lead to very ugly places. Trust me, I’ve been there. I would not wish the past six years of my life on anyone. Not even the devil himself. It’s been worse than hell.

As you struggle to fight your way back, please remember that your husband has been right there with you. Hopefully he jumped into the trench with you instead of staying on the sidelines watching you battle your way down field as you kick PPD toward the goal of Good Riddance. But if he stayed on the sideline, don’t count him out. He might be scared. He might be depressed himself. Or he might be self-medicating with alcohol and drugs. And just as you have expected space in which to heal, he too deserves the same space in which to heal himself. The both of you deserve permission to not be okay if that indeed is what’s going on with you.

If your husband is not responding to any of your attempts to get him involved, it may be time to take him to a doctor /therapist appointment. He may have questions he needs answered. Or he may be unsure of anything he can do to help. Or he may be struggling himself. Regardless, many men find solace in hearing facts straight from a professional. It’s not personal, ladies. It’s just the way some men operate. The degree/training matters.

But what if your husband/partner disagrees with your choice of treatment? If your treatment option is working for you and has been discussed with a medical professional, quite frankly, it doesn’t matter what anyone else things, even your husband or partner. YOU are the one who has to live with you. YOU know what works and what does not. Do not let anyone bully you into switching to a form of treatment you are not comfortable with or does not work. It is okay to shop around for a good doctor or therapist but do not use “I did not click with Therapist X” as a reason to stay away from help, as @postpartumprogr pointed out in yesterday’s #PPDChat.

There were quite a few ladies at yesterday’s #PPDChat discussing this very topic. But I wanted to open it up to those of you who read the blog but don’t/can’t make it to our Twitter Chats on Monday.

A few of the questions asked at Chat were:

Did your husband notice there was something wrong before you did? Did he tell you? How did he tell you? How did you react to this news?

What advice do you have for other dads/partners who might be struggling to figure out how to tell their loved one she/he needs mental health help? What approach worked for you?

What are some simple things Dads can do around the house to help Mom out after the birth of a baby? What were some little things your own husbands did for you that made a big impact?

Dads? What advice do you have for Moms? Anything we can do to try and help you out in the midst of all of this? Realize we are not capable of a lot when we are incapacitated by a Postpartum Depression but a little knowledge and insight goes a looooong way.

Please share any resources you have found invaluable not only for Postpartum Mood Disorders but for marriage as well.

Let’s get to Just Talkin’ on this Tuesday!

(P.S. If you choose to answer this on your own blog, grab the above button and link it back to this post with your response! Thanks!)

Tonight’s PSI Chat with an expert will take place at 9:00p.m. EST with Susan Dowd Stone.

Callers may remain anonymous and don’t even have to say anything if you so desire.

To participate, just dial 1-800-944-8766 five minutes before the call is scheduled to begin. You must enter the Participant Code (listed below) A maximum of 15 callers is allowed. Facilitators will end the call 15 minutes after starting if there are no participants. For detailed instructions click here.

When the Mayflower left England, three pregnant women were aboard. Two of these mothers were seven months pregnant, one of them just three months along. They bravely faced the unknown and left England’s safe haven behind for the New World. One mom gave birth aboard the Mayflower while en route. The second mother gave birth once the ship arrived and had docked in New England. The third mother gave birth a few months later but unfortuately lost her life during childbirth. Her infant son was also lost. Only one child/mother pair survived. The child born while en route was lost during the first harsh New England Winter.

Life was very difficult indeed. Strict rules abounded regarding family life and there were little if any resources available to mothers for support and carrying out household duties. More often than not during the first tumultuous years one did not know from day to day if they would have enough food to even survive to the following sunrise. Leaning on faith and God were about all they had. The Pilgrims learned from the local Indians and relied heavily upon the land to provide them with resources. They ate ground nuts, killed local fowl, fished, and began to learn to plant crops with the Indian’s help.

Mothers were expected to be meek and demure, quiet and obedient, faithful and pure, to love their husbands as they loved Christ and their husbands were to be the Head of Household, to love their wives as Christ loved the Church and function as the religious and moral compass of the household. Children were strictly raised – even playing was seen as a sinful waste of time by the Puritans and children were even forbidden from playing on the Sabbath, perhaps an explanation of why children attended church sermons with their parents that often lasted six hours or more. Prayers were held twice daily, and the Bible was often the first book to which children were exposed. In fact, religion played such a large role in early American life that 80 percent of 17th century New Englanders had an Old or New Testament name. The name was often given at the baptism, something the Father of the family was responsible attending to when the child was two weeks old as “the mother at that time by reason of her travaile and delivery is weake and not in case to have her head troubled with much cares.” Nice to see they realized that mom needed a break even if it was from something as simple as baptizing her child.

Childbirth in early America was a difficult task as many children and mothers were lost during this time. Even in the healthiest of communities, 10 percent of children did not make it through their first year and three out of nine died before their 21st birthday. Yet families were large and a new child typically made an appearance every two to three years. Cotton Mather, a well known early preacher, saw eight out of his fifteen children pass away before the age of two. This loss came to be expected but still wrought the parents with grief. Puritan belief led that children were born into sin and were not innocent as is now believed therefore the loss of a child would seem to be that much harder – not being able to believe your child has gone to be with the Lord.

Wetnursing was popular but did not fade immediately. Weaning was also done quite differently than it is today – maternal illness, pregnancy, acquisition of teeth (which as you nursing mamas know can be VERY painful!), or conflicting constraints on a mother’s time were all legitmate reasons to wean. Reasons sound familiar – method was very different. Weaning was not done slowly as it is today. It was done quickly. Either the child or the mother would visit a relative’s home until the weaning process was over. Once the child had given up nursing altogether, the family used the child’s name rather than the lovely endearing term of “it.”

The long robes and petticoats children were dressed in served to encourage children to walk rather than crawl like animals. Sometimes even wooden dowels were strapped to children’s backs to aid in achievement of proper posture. Neck Stays were even used to keep infant’s heads upright. (OUCH!)

Pilgrim families had it rough and there is no denying that when you have mounds and mounds of text telling you so. But they survived. They survived harsh winters not knowing how they were going to feed their families. They survived the loss of their children, their homeland, their loved ones, their traditions. But out of this struggle a bright light shone through and enabled them to grip to hope and form new traditions, new lives, new family structures. They adapted and developed new ways of handling whatever difficulties traveled their way. If they hadn’t, we wouldn’t be here today. If you take nothing else away from this article, take away this. Life isn’t about what happens to you. It’s about how YOU happen to life. The next time something difficult happens? Take the Pilgrim way out – dig in, grit your teeth, put your head down, and plow right through it. Tomorrow is a new day and if they did it, SO CAN YOU!

Adrienne has been volunteering with PSI for about as long as I have and is located in VA. She recently launched her own non-profit, Postpartum Support Virginia.Not only is she one dedicated woman, she’s from my home state, VA. Gotta show the love, right?

Her first postpartum experience was awesome – she even held a dinner party for 40 people when her new daughter was just three months old! (YOU GO GIRL!) It was with her second child that events quickly spiraled out of control and Adrienne found herself struggling for someone, anyone, to listen compassionately to her and show her the way back out. Finally her husband located a physician who specialized in women’s mood disorders. Adrienne began to recover having finally located the correct help. Her third pregnancy was a lot like mine – she stayed on her meds, educated her doctors (even received an apology) and received a screening questionnaire at her 6 week checkup. (By the way, HAVE you written or called your Senator about the MOTHER’S ACT yet?) Impressed with how far the medical community had come, Adrienne felt great and was now fully dedicated to improving things even more. Read on to find out more…

Just like me, you’ve been driven to help other Moms struggling with PPD through an experience of your own. Would you mind sharing that experience with us and why it inspires you to help other mothers?

After my second child was born six years ago, I had a fairly significant episode of postpartum depression and anxiety. I knew something was wrong because everything about this birth and postpartum period was the opposite of my first experience with childbirth two years earlier. My second delivery was rather traumatic (emergency C-section); my second baby ate more, slept less, and cried more than my first; I had a toddler AND a newborn (which I believe is the hardest stage thus far of parenting); I was totally sleep deprived; and I just couldn’t imagine how I was going to survive the next 18 years until this baby went off to college, never mind the next 5 minutes. Compounding my misery was the fact that my next-door-neighbor had just had her second, and my sister just had her fourth, and they made it look so easy.

The hardest part was finding help. Despite realizing that something was terribly amiss, I couldn’t find the help I needed — or at least the help I wanted. At my 6-week postpartum, I told the OB/GYN that I wasn’t feeling well, and without any discussion she offered me Prozac. When I called the Behavioral Medicine branch of my HMO, I was hoping for a verbal hug from someone who could reassure me that others had felt like this and that help was available. Instead, I was told to call back during normal business hours, overheard the intake nurse tell her supervisor I was “homicidal”, was told that they would report me to Child Protective Services if I had hurt my children, and was charged two co-pays since I saw a nurse AND a doctor. The psychiatrist recommended sleeping pills — I wasn’t sure if he meant for me or for my baby. I called mental health providers but couldn’t find anyone accepting new patients. I called about support groups, only to be told that they were now defunct. I saw a psychologist for several months who never understood how desperate I was. I felt like I was banging my head on a brick wall. Finally, when my son was six months old, my husband located a psychiatrist who specializes in women’s mood disorders and gave me the reassurance and care I needed.

I vowed during this time that I would someday do something so that others could find help more easily. This isn’t rocket science. PPD is relatively easily diagnosed and treated. The hard part is getting information to new mothers and connecting them to health care resources.

Tell us about your organization, Postpartum Support VA. How long has this been in the works and what does it feel like to finally have it up and running?

Postpartum Support Virginia is a not-for-profit organization providing hope and help for new mothers through:

support for new and expectant mothers (one-on-one and group support)

information and resources for new mothers and their families

outreach and education

I think of it as an umbrella covering all the activities ongoing in Virginia dealing with postpartum depression. The website (www.postpartumva.org) lists telephone and email volunteers, support groups, and mental health professionals who treat women with postpartum depression and other perinatal mood disorders.

I’ve been thinking about creating an organization like Postpartum Support Virginia for about three years, ever since I started to volunteer with mothers experiencing postpartum issues. But with three young children (they are now 8, 6 1/2, and 3) I couldn’t devote the time and energy until now. My approach has been to build the infrastructure first, then put the superstructure in place.

In other words, I’ve spent the last few years laying the foundation — helping other volunteers get started, speaking to maternal/child health care providers, leading support groups, networking with others involved with PPD throughout Virginia, attending PSI conferences. The past six months have been about formalizing these operations — creating a not-for-profit organization, building a website, creating a board of directors. The next few months will be focused on fund raising. Postpartum Support Virginia is still in its infant stage, and I really feel like I’ve given birth to my fourth child.

What do you find to be the most rewarding about helping other PPD Moms and families?

There is such joy in helping these new mothers who are swirling around in the whirlpool of depression and anxiety. To see the change after they get the help they need is so rewarding. In particular, seeing a new mother fall in love with her baby is amazing. And to receive feedback like this email from a mom who attended one of our support groups makes it all worthwhile:

“Thank you from the bottom of my heart. The knowledge and encouragement that you all gave me in only 2 visits put me on the path to a better life than I ever could have imagined. I went from the worst time in my life to the happiest I have ever been so I am very grateful. Thank you so very much.”How did your husband handle your PPD? Any advice for dads struggling to cope with their partner’s PPD?

My husband kept our little family going while I had PPD. He researched this illness and found the psychiatrist who finally helped me. He would come home from work at a moment’s notice when I was falling apart. Whenever I feel guilty about how he carried me through this time, he reminds me that is what marriage is all about. Spouses who see their partners suffer PPD, please remember that this is not her fault, you are not alone, and with help she will be well again.What is the most challenging thing about motherhood?

The most challenging thing about motherhood is being mentally present for each of my children. They are each so special and unique, requiring different parenting skills from me, that it takes time and energy to give each what s/he deserves.What is your most favorite thing about motherhood?

The same as all other mothers – BEDTIME! Just kidding.

Three things:

I love making my children smile.

I love seeing the progression towards independence, which is bittersweet but the goal of good parenting.

I love watching the sibling relationship develop.

How long have you been a PSI Coordinator and how did you first find out about PSI?

I have been a PSI coordinator for two years. I heard about PSI from another PPD survivor and volunteer, Benta Sims, who raved about the conference she attended a few years ago. Joining PSI gave me the sense of connectedness and credibility that I needed to do this type of volunteer work.

What do you do when you take time for YOU?

Oh, I take LOTS of time for me to ensure I have time and energy for my family. On a daily basis I exercise and nap — in fact, I have taken a nap virtually every day since I was pregnant with my first child almost 10 years ago. I go to bed at 10:00 every night (except tonight while I am answering these questions!). I see a therapist, go to a chiropractor, get monthly therapeutic massages, and practice yoga. I host coffee once a week with three great neighbors — we solve each other’s problems and keep each other on track. And I have terrific in-laws who take my children for a few days once a year so I can revel in being alone in my own home. This is the best gift ever — and usually when I fall into a novel and read non-stop for two days.

How do you balance motherhood and work?

Balancing motherhood and work is extremely difficult, as most mothers know. I don’t really consider what I do as “work” because I find it so fulfilling — and because I don’t get paid (yet). The way I balance it is being my own boss. I know that at this stage of life I wouldn’t be happy with someone telling me what to do, answering to someone else’s demands or expectations or schedule, and forcing my children into my work schedule. So with my own organization, I can do what I want when I want.

Practically speaking, it means working while my children are at school or at night so I can be fully present for them while they are at home. During the summer I hire a babysitter a few mornings a week to take my children to their swim team or the park while I work from home. I’ve been ramping up slowly, but this year will be a big turning point as my youngest starts half-day preschool.Finally, if you had a chance to pass on just one piece of advice to a new mom (experienced or not), what would you share with her?

Today we are continuing with our focus on Dads and we will be reading up on a condition that is just starting to gain recognition – Paternal Postnatal Depression or PPND for those of you who love acronyms.

Dr. Will Courtenay has been working in the field of Men’s Health for quite some time and is internationally recognized for his achievements in his field. According to his bio at Postpartum Men, Dr. Courtenay received his Ph.D. from the University of California at Berkeley and is a Licensed Clinical Social Worker. He is a member of the visiting clinical faculty in the Department of Psychiatry at Harvard Medical School, and has formerly served on the clinical faculty of the University of California, San Francisco, Medical School. Dr. Courtenay also serves as a Coordinator with Postpartum Support International.

In addition to his psychotherapy practice, Dr. Courtenay has spent the last 15 years researching and writing about men’s physical and mental health concerns, and effective strategies for helping men. His work is referenced by researchers throughout the world and has been translated into many languages. Currently, the focus of his research and writing is men’s experiences after the birth of a child – and effective strategies for helping men with postpartum depression.

I am excited to be able to share this interview with you and hope you leave enlightened and open to th very real condition that affects new fathers.

Thank you Dr. Courtenay for your hard work in this area and I also thank you for the time you put into this interview. I know it continue to shed light on a topic that has been in the dark far too long.

What led you to become a Psychotherapist specializing in men’s issues?

Wow! That question takes me back to being a teenager in the late 70s! That was when the Comprehensive Employment and Training Act, or CETA, was enacted. My first social work job was being a CETA worker in San Francisco. I helped teenaged boys – mostly runaways, who were living on the streets of the inner city – to find jobs and housing. After that, I worked in a variety of jobs helping men as a social worker while I continued my education.

After I began my psychotherapy practice, and while I was working on my PhD at the University of California at Berkeley, I became very curious about the silence surrounding men’s issues. No one was talking about them – not doctors, not mental health providers, not the media, and certainly not men themselves. I was shocked to learn, for example, that men were dying nearly eight years younger than women, and yet there was no discussion about it. Most people – including doctors – were not even aware of this fact. And men’s mental health wasn’t any better. Men were killing themselves at rates up to 12 times higher than women were. But again, there was a deafening silence.

So, about 15 years ago, I founded Men’s Health Consulting (www.MensHealth.org). An educational and consulting firm focused on educating health professionals and the public about the health of men and boys, and how to best provide health services to men. That was long before most people had heard of Men’s Health Magazine. Finally, things have changed and men’s health is getting more of the attention it deserves. But now, men’s postpartum depression is where men’s health was 15 years ago – completely in the dark.

The focus of my work as a researcher and social scientist is masculinity. What I discovered is, men’s attitudes about manhood have a direct influence on men’s health and well-being. Take for example, the fact that many men were taught as boys to never cry – and that they were often punished when they did. So, it’s no surprise research shows that men are more likely than women to try to hide their depression – which only worsens the depression. Men are also taught to be tough, self-reliant and never ask for help. This then makes it difficult for men to get the support and professional help they need to recover from depression – and can lead to feelings of shame or embarrassment when they do.

It really pains me to see so many men suffering alone, and in silence. Especially since depression, anxiety and the other emotional problems that affect us are effectively treatable. So, helping men to lead the most fulfilling lives they can – primarily through raising public awareness and through my psychotherapy practice in Berkeley, California – remains a lifelong passion.

When did you first begin to see an increase in men experiencing Paternal Postnatal Depression?

Well – to be honest – what first springs to mind when I hear that question is a really bad analogy: buying a car and suddenly noticing how many of the same cars there are on the road. But the fact is, until you recognize that this problem of postpartum depression in men exists, you don’t see it. Once you know about it, you start to see just how common it is.

The fact is, we don’t know if there actually is “an increase” in Paternal Postnatal Depression (PPND). It’s only relatively recently that the problem has been identified. That doesn’t mean it’s new, it just means we hadn’t identified it before. There probably have always been men who’ve experienced postpartum depression.

Part of what drew my attention to the problem, was becoming a father myself and starting to think more about the experiences of men as fathers. At the same time, I had been watching many of male patients becoming fathers. In fact, it was actually in my clinical practice – working with men who became fathers for the first time – when I first saw men experiencing depression after their babies were born. That’s when I started researching the subject.

What is the occurrence rate for PPND and what are some of the risk factors for developing PPND?

Well, the occurrence rate is surprisingly high. Every day, more than 1,000 men in the United States become depressed after the birth of their children. And according to some studies, that number is as high as 3,000. That’s means that as many as 1 in 4 new dads experience PPND.

The “risk factors” for PPND are basically those things that we believe might cause PPND (see below). Men who are concerned about developing PPND – or concerned about already having PPND – should look over the list of possible causes to see whether they might be at risk.

Would you describe some of the classic symptoms of PPND? What symptoms would warrant a psychiatric emergency?

It’s a great question – and certainly a reasonable one. But it opens a whole can of worms.

“Classic” is probably not the best term to use in this case. PPND is a relatively newly recognized problem. Now that doesn’t mean that fathers haven’t always experienced this problem, it just means we’re only beginning to learn about it. So, because of that, we don’t really know what the “classic symptoms” are. The same is true of men’s depression, in general. What we’ve long thought of as classic symptoms of depression, may have blinded us to the actual symptoms that men experience.

When we think of a depressed person, we usually picture someone who’s sad and crying. But picture instead a guy who’s working 60 hours a week, being a little short-tempered, drinking a couple of martinis at lunch, slipping out of the office to have an affair, and then speeding home to his wife in the evening. Now that’s not who we think of when we think of someone who’s depressed, but these are some of the symptoms of men’s depression – which often looks different than women’s depression. This is part of what makes it easy to overlook men’s depression.

Here are some symptoms of men’s depression or PPND:

§Increased anger and conflict with others

§Increased use of alcohol or other drugs

§Frustration or irritability

§Violent behavior

§Losing weight without trying

§Isolation from family and friends

§Being easily stressed

§Impulsiveness and taking risks, like reckless driving and extramarital sex

§Increased concerns about productivity and functioning at school or work

§Fatigue

§Experiencing conflict between how you think you should be as a man and how you actually are

A man who’s depressed won’t experience all these symptoms. Some men experience only a few of them, while others experience many. And how bad these symptoms get also varies among men – and over time.

Now, that said, it’s important to point out that men with PPND can also experience “classic” symptoms of depression – such as a sad mood, loss of interest in hobbies or sex, a change in appetite, a sense of worthlessness, poor concentration, and thoughts of suicide. Certainly if a man is thinking about suicide, that would qualify as a psychiatric emergency. We have to remember that men commit suicide anywhere from 4 to 12 times more often than women do. Each day, 75 men in the United States take their own lives. So, any thoughts of suicide in men need to be taken very seriously.

As you can probably tell from this description, PPND is different from the “Daddy Blues” – which many new dads can experience. With normal postpartum stress or the Daddy Blues, a guy’s going to feel better when he gets a little extra sleep, when he goes to the gym, or when he has lunch with a buddy. But with depression, these things won’t make him feel better. With depression, the symptoms are more severe and they last longer. So, if the Daddy Blues last more than two or three weeks, a man’s probably depressed – and he should get help from a mental health professional who specializes in working with men. Left untreated, postpartum depression often worsens.

It’s also important to keep in mind that men are more likely than women to try to hide their depression. And many men are very good at this. In fact, they’re so good at it, they don’t even recognize their depression themselves. So, looking out for any sign of something unusual is critical. The best sign might simply be hearing from his partner, “Honey, you haven’t been yourself lately.”

It’s also important to point out that, even if new fathers don’t have “clinical” symptoms, they can sometimes just feel miserable – and completely alone in their misery. It’s not uncommon for me to hear from men, “I just don’t feel any connection to my baby.” For some men, it’s even harder than this: they can’t stand to be near their baby. They can’t stand the smell of their baby. Or, for other men, they can’t stand to hear their baby cry; just hearing their baby cry makes them completely crazy. And then, on top of that, these men feel horribly guilty for thinking or feeling these things.

What are the causes of men’s Postpartum Depression?

To be frank, we can’t be definitive about the causes of PPND – at least at this point. But, that said, there are a number of factors that research suggest might be possible causes.

It’s likely that sleep deprivation plays a major role in triggering men’s depression. We know that normal, healthy adults who are deprived of good sleep for just one month begin to develop all of the clinical signs of depression. So, sleep deprivation is a very likely cause.

Hormones may also play a role. Everyone knows that pregnant women and breast-feeding mothers go through hormonal changes, but men’s hormones change too. A man’s hormones change both during his partner’s pregnancy and during his baby’s infancy. And it’s a double whammy: not only do our testosterone levels go down, but – at the same time – our estrogen levels go up. Which means less male hormones and more female hormones coursing though our bodies. One man I know got glassy-eyed just learning this; he finally had an explanation why he’d suddenly “broke down in tears” the week before when he saw a squirrel on the street get hit by a car. These hormonal changes can wreak havoc on a man’s life, and may help set the stage for postpartum depression. In fact, there is some evidence linking decreasing testosterone levels with increasing risk of depression in men.

Now, the thing that best predicts whether a man will become depressed is whether his partner is depressed. Half of all men whose partners have postpartum depression are depressed themselves. Part of what I think explains this, is the new father’s loss of his partner to her new job that keeps her occupied 24/7 – and being left on the sidelines while mommy and baby are bonding. We know from lots of research that men have fewer friends and smaller social networks than women do, and that – for many men – their female partners are their primary source of support. The loss of this support – which, of course, is even greater when the mother is depressed – might be a trigger for depression in some men.

Here are some other things that may increase a man’s chances of experiencing PPND are

§Personal history of depression

§Relationship stress – with a partner or with in-laws

§Excessive stress about becoming a parent or father

§A sick or colicky baby

§A lack of support from others

§Economic problems or limited resources

What steps can a man with PPND take to get better and what is the average length of the recovery period?

Well, the good news is that postpartum depression and anxiety are very treatable. Men don’t have to continue suffering. And although these conditions are very serious – and sometimes life-threatening – men can fully recover.

Research shows that the best way to “get better” (or the best treatment) when experiencing depression, is a combination of talk therapy and medication. Now, “talk therapy” can be a scary idea for many men. If that’s the case, then a man should think of it instead as getting some consultation or coaching. The fact is, every man needs a teammate – or a coach – at some time (and sometimes many times) in his life. And if he’s suffering from PPND or depression, that’s one of those times. The important thing is that a man rally with himself to gather the courage necessary to get the help he needs to recover.

It’s also important that he see a psychotherapist who’s trained in working with men. The fact is, we mental health clinicians are human. We’ve grown up with the same stereotypes about men that everyone else has. These stereotypes about how men are supposed to be can often blind clinicians to men’s pain In fact, research shows that trained, mental health clinicians are less likely to correctly diagnosis depression in men than in women. Because of this, and the unique needs men bring to therapy, a man should see someone who has been trained in working specifically with men.

Now, if a man doesn’t get help, it can result in damaging, long-term consequences. Left untreated, we know that postpartum mood disorders often worsen – and they can ruin a man’s marriage or his career, and can lead to serious financial problems. We also know that a father’s PPND has a negative impact on the emotional and behavioral development of his child 3-5 years later.

Suicide, of course, is the most tragic consequence of depression. As I mentioned above, suicide rates are much higher for men than for women. In fact, three U.S. men kill themselves every hour of every day. And men’s depression doesn’t just lead to suicide. Men with depression are twice as likely to die from any cause compared to those men who aren’t depressed. That’s why I call depression “men’s silent killer.”

The truth is, the biggest problem with men’s postpartum depression isn’t the depression itself, but the fact that too many men try to go it alone and don’t get treatment. That’s the worse thing they can do. Men need to recognize that depression is a medical condition – it’s not a weakness of character. For a man to admit he’s depressed isn’t unmanly or admitting defeat; it’s taking charge of his life.

The important thing to remember is that all of the negative consequences of men’s depression are avoidable. With proper treatment and support, men can fully recover from PPND. And if a man can’t do it for himself, he should consider doing for his marriage or the well-being of his child.

Unfortunately, we don’t know how long it takes men to recover from PPND; it’s never been researched. But men should keep in mind that their depression may have been years in the making; it may not disappear overnight. Even a man who recognizes he’s depressed and gets help – by talking to a psychotherapist or consultant right away – can still take a while to recover. If a man starts taking antidepressants, for example, it usually takes the medication 8 to 12 weeks to reach a therapeutic level. The recovery time will also vary depending on what the man’s emotional well-being was like before he became a father.

Now, all of that said, it’s also worth mentioning that – in my experience – men often report at least some relief almost immediately after talking to a mental health professional. That sense of relief often continues until they fully recover from depression.

How can a partner support her husband if he is suffering from PPND?

The number one way a partner can support her husband is by being patient. And the second – and the third – way she can support her husband is by being patient. This is especially true if her husband has already acknowledged that he might need some help.

The fact is, it can take a while for a man to get help – even after he’s decided to do that. And then once he gets help, it can take a while for him to recover. I just heard from a man last week that his wife had been very understanding of his becoming depressed – at first. But when his depression persisted – as it often does, even after beginning treatment – she got impatient. That won’t help a man’s recovery at all.

For the woman who wants to help her husband to get the help he doesn’t know he needs, but she knows he needs, I’d suggest that she look to what’s worked for her in the past. What powers of persuasion has she used that have worked most successfully in the past? What worked when she wanted her partner to do something he didn’t want to do – like cleaning out the garage or mowing the lawn? She should think about these things and what’s worked to influence him in the past. What works is going to be different for every man.

She should also be careful with the words she uses to talk about getting help. She might be comfortable with the notions of “therapy” or “personal growth,” but her partner might not be. It’s a lot safer for her to suggest that he consider some “coaching” or “consultation.” If she’s considering finding some referrals for him, she should try to find someone who’s experienced in working with men.

If both the mother and father are suffering with a Postnatal Mood Issue, what steps should they take together to protect their marriage and the child?

Well, the first thing they should do is to take a deep breath. Then, they should fasten their seat belts and make sure their tray tables are in the upright position.

Now, I don’t want to make light of this most challenging of postpartum situations. But the truth is, it is going to be a very bumpy ride. And, these parents need to be prepared for how bumpy it’s going to get.

Parenthood is hard. Let’s face it; it’s hard for all of us. And, of course, it’s also often filled with pure joy. But, it’s still hard. In fact, three out of four couples say they became dissatisfied with their relationship after their first child was born. That’s because taking care of a new baby is challenging – for most parents. But with postpartum depression it’s different; it’s painfully challenging. And when two parents are depressed, it’s doubly, painfully challenging.

This question is particularly relevant, because we know that half of all women who are depressed have male partners who are also depressed. And – if both parents are depressed – the negative impact on their child’s emotional and behavioral development is even worse than if one parent is depressed.

The truth is, “baby bliss” is something that appears more often in movies and Hallmark cards than in the homes of new parents. Yes, some parents experience what appears to be a seamless transition into parenthood. But I believe that’s the exception. For most parents, it’s more like baby boot camp. (And it’s not the babies who are in training.)

If both mother and father are depressed, professional help is definitely needed – for both of them, individually and as a couple. That means finding an individual psychotherapist for him, one for her, and a couples therapist for both of them. I know it sounds like a lot of talk therapy, but the fact is, that’s the best chance of getting them through this.

Social support for both of them – individually and as a couple – is also going to be important. Involving family can be helpful, but only if the family members involved are supportive of both partners and the relationship. Getting involved in an online forum – like the online forum at www.SadDaddy.com for new fathers – is important. This may be especially true for men, who may be more comfortable getting support in a way that are anonymous.

Probably the best thing couples can to do to protect their marriage – and their child’s development – begins before the baby is even born. Expectant parents should assess both the mother’s and the father’s risk for experiencing postpartum depression (see the question about risk factors). They can go to my web site, www.SadDaddy.com, and check the list of things that can put a man at risk. There are also resources there for new and expectant mothers.

If a man’s at risk for PPND, he should start getting prepared for the possibility that he might become depressed before the baby is born. Building a network of support made up of friends and family – and putting this in place before the birth of his child – is like putting money in the bank. The expectant father can also join a men’s group or a new father’s group.

For men, the best resource is my web site, www.SadDaddy.com. There’s a lot of information, and resources, about men’s postpartum mood disorders, an assessment specifically designed for men to help them determine whether they might be depressed, and an online forum for new dads to talk with one another.

Just as with PPD, is it possible for a father to be ok after one birth and still experience PPND with a subsequent birth?

My guess is, yes. But that’s only a guess; an educated guess. The problem is, we don’t know. We’re only know beginning to understand PPND, and the chance that it can occur after a previously uneventful postpartum experience is unknown.

If you could give an expectant father (new or experienced) just one piece of advice, what would it be?

Have the courage to get help, if you think you might need it. And, if you can’t do it for yourself, do it for your kid’s sake.

And – if I could add a second piece of advice – it would be, be patient with yourself. Parenting is harder than you think. It’s harder than anyone thinks – or anticipates – it will be. It is, as they say, the hardest job you’ll ever have.

And it’s even harder now, when men are expected to be more involved in parenting. Most dads – with their typically can-do approach to things – say, “Sure, of course I’ll be more involved in parenting.” But then they wonder, “What does that mean?”

The fact is, they can’t answer that, because most of these guys had dads who took a completely hands-off approach to parenting. So, that leaves these new dads – who never learned parenting skills from their own dads – uncertain about what to do. Unfortunately, this uncertainty can quickly lead to anxiety – and we know that anxiety postpartum often leads to depression.

Recognizing this – and just how difficult the job of parenting is – will help new dads to cut themselves a little slack. Hopefully, if they can be patient with themselves while they learn this new job, they’ll enjoy being a dad a whole lot more.

A Note

Please note any information found on this blog is not meant to replace that of a qualified professional.
We encourage partnership with your physician, psychiatrist, and therapist in the treatment of mood disorder.
The information found here is educational and anecdotal and should be reviewed with a professional prior to implementation.